Document Type

Dissertation

Degree

Doctor of Philosophy

Major

Psychology, Clinical-Community

Date of Defense

7-14-2026

Graduate Advisor

Ann M. Steffen, Ph.D., ABPP

Committee

Stacy Ogbeide, Psy.D., ABPP

Emily Gerstein, Ph.D.

Sharon Johnson, Ph.D.

Abstract

Within primary care, the Primary Care Behavioral Health (PCBH) model integrates behavioral health services into medical settings through brief, population‑based interventions delivered by behavioral health consultants (BHCs). Although effective performance in this role requires competencies distinct from traditional mental health practice, few psychometrically sound tools exist to assess clinical skills in primary care. The Brief Intervention Competency Assessment Tool (BICAT) is commonly used for this purpose but lacks published evidence supporting its reliability and validity. This dissertation examined the psychometric properties of the BICAT across two studies. Study 1 evaluated factor structure, internal consistency, and construct validity in a heterogeneous sample of integrated primary care clinicians and trainees. Exploratory factor analysis supported a strong general factor underlying BICAT items; despite an empirically derived two‑factor solution, high factor intercorrelations supported retention of a unidimensional structure. The BICAT demonstrated excellent internal consistency and strong convergent validity with theoretically related integrated care practices. The BICAT also showed a small negative, non-significant association with prohibited practices, providing limited evidence for discriminant validity. Study 2 examined the BICAT among counseling trainees enrolled in a structured PCBH training program. Results indicated strong internal consistency at pre‑ and post‑training, robust convergence with an established measure of clinical practice competency, and large pre‑ to post‑training improvements, demonstrating sensitivity to change. Findings support the BICAT as a reliable, valid, and training‑responsive measure of brief intervention competency in primary care behavioral health settings.

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